“There’s still a lot we don’t know and need to learn about,” Bauer says. “We’re continuing to learn there’s maybe a role for preventing RA and maybe catching it early. Going forward that will really be a big area with ongoing studies.”
For example, research suggests that first-degree relatives with RA or who are positive for certain antibodies may benefit from early treatment—even before and overt diagnosis of RA, Bauer says.
“I could see that in the next year or so gaining traction,” she adds.
Another factor in the management of RA is a change in mindset for providers. In the past, RA was diagnosed by its advanced and crippling presentation. Now, suspected RA is treated early, hopefully before extensive damage occurs, Cohen says.
“In the old days, we weren’t as aggressive. We waited for the diagnosis, and we waited for radiographic proof of erosions,” Cohen says. “We don’t really want to do that anymore. By the time we see that the game is almost over.”